Cryoablation May Offer Oncologic Control in cT1 Solitary Renal Masses

Cryoablation was associated with good short-term oncologic control and an excellent safety profile in “healthier” patients.
Cryoablation was associated with good short-term oncologic control and an excellent safety profile in “healthier” patients.

ORLANDO, FL Cryoablation was associated with good short-term oncologic control and an excellent safety profile in “healthier” patients with cT1 solitary renal masses, according to a single-institution study presented at the 2017 Genitourinary Cancers Symposium.1

"A study by Thompson et al showed no significant difference in metastasis-free survival at 5 years between partial nephrectomy and cryoablation in patients with cT1 renal masses," said lead study author Harras B. Zaid, urologist at the Mayo Clinic in Rochester, Minnesota. "Local recurrence-free survival rates 3 years were not different between the 2 groups."

Current guidelines suggest that percutaneous thermal ablation can be used in place of surgery for patients with significant comorbidity ineligible for surgery, though there are limited data on the use of percutaneous thermal ablation for healthier patients who are otherwise candidates for surgery.

To investigate the outcomes of cryoablation among healthier patients electing to undergo percutaneous thermal ablation, Dr Zaid and his colleagues performed a single institution review of prospectively maintained ablative data collected between 2003 and 2015. The researchers included only patients 65 years or younger with solitary, non-metastatic renal masses less than 7 cm who had an ASA score of 1 or 2 and a preoperative eGFR greater than 60.

The investigators identified 43 patients who were deemed to be healthier by the inclusion criteria. Of those, 16.3% had undergone prior partial nephrectomy and nearly a quarter had undergone multiple prior abdominal/pelvic surgeries.

Results showed that 2.3% of patients developed local recurrence during a median radiologic follow-up of 22 months and 4.6% developed metastatic disease. Both patients who developed metastases had prior contralateral nephrectomy for RCC with high risk pathology. No patients died from RCC during this period.

RELATED: Safety of Active Surveillance for Small Renal Masses

"There is a potential role for repeat ablation following local recurrence, but longer follow-up data are needed to evaluate for durability," said Dr Zaid.

Reference

  1. Zaid HB, Atwell TD, Schmit G, et al. Cryoablation of cT1 renal masses in the “healthy” patient: Early outcomes from Mayo Clinic. Paper presented at: 2017 Genitourinary Cancers Symposium; February 16-18, 2017; Orlando, FL.

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